Provider Demographics
NPI:1326602483
Name:LOPEZ, RUTHZAINE (MD)
Entity Type:Individual
Prefix:
First Name:RUTHZAINE
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 WISCONSIN AVE NW STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2265
Mailing Address - Country:US
Mailing Address - Phone:202-944-5400
Mailing Address - Fax:855-771-6849
Practice Address - Street 1:2115 WISCONSIN AVE NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2265
Practice Address - Country:US
Practice Address - Phone:202-944-5400
Practice Address - Fax:855-771-6849
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2023-06-14
Deactivation Date:2020-02-26
Deactivation Code:
Reactivation Date:2020-02-26
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCNA2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program